| NPI | 1770528341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1133023) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT2656) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2007-07-09 |